Key Takeaways

If you have psoriasis, you’ve probably already identified triggers that aggravate your disease and make your symptoms worse. According to the National Psoriasis Foundation (NPF), triggers can be internal factors such as stress or external ones like the weather, and they tend to vary from person to person. Although eliminating or minimizing triggers won’t cure psoriasis, it will help you manage the disease and limit flare-ups.

Here are seven triggers to be aware of — and what you can do about them:

1. Unhealthy habits, such as smoking and drinking too much alcohol. A meta-analysis of a large group of studies found a definite link between smoking and psoriasis, explains Jessica Kaffenberger, MD, a dermatologist at The Ohio State University Wexner Medical Center in Columbus. Dr. Kaffenberger says that not only are smokers more likely to have psoriasis, but they tend to have more severe cases of the illness. Smoking also raises your risk for heart and lung disease. This is a double whammy for people with psoriasis, who are already at higher risk for these diseases even if they don’t smoke. Drinking too much alcohol can also trigger flares and may interfere with treatment.

2. Carrying excess weight. “Body mass [a measure of body fat] is higher in psoriasis patients than in the general population,” says Susan Katz, MD, clinical assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Langone Medical Center in New York City. Although doctors can’t yet say that being obese causes psoriasis, there is a relationship between psoriasis and metabolic syndrome — a collection of symptoms such as high blood pressure, high cholesterol, poor sugar control, and abdominal fat that increases the risk for heart disease and diabetes.

“This interplay goes along with changes in skin and fat cells related to psoriasis and the lining of blood vessels,” Dr. Katz says. “There’s a lot of correlation between a healthy diet and exercise and psoriasis. These things are good for your general health and can only help with your skin, not make it worse.”

3. Medications. According to the NPF, some medications — even those used to treat psoriasis — can cause problems. Katz says that when patients overuse medications such as strong topical steroids and then stop using them, they can have a rebound effect and trigger symptoms. Certain groups of drugs, such as common blood pressure and heart medications, can worsen psoriasis symptoms. If you suspect a medication is affecting your psoriasis, ask your doctor if they can prescribe an alternative. Follow directions carefully for all medications.

4. Infections. There is a strong correlation between strep infections in children and guttate psoriasis. In fact, the NFP says up to one-half of young people with psoriasis may experience a flare several weeks after a strep or other infection. Guttate psoriasis is the second most common type of psoriasis and is characterized by small, dot-like lesions. Prompt treatment of infections may help the psoriasis go into remission.

5. Stress. “Stress is a big trigger,” says Katz. There is a correlation between skin disease and stress, turmoil, not sleeping, or drinking alcohol.” In fact, the NPF says stress can even cause the onset of psoriasis as well as aggravate existing symptoms.

Find ways to manage stress that work for you. Exercise, meditation, and yoga are all effective. So is having a good family and support network, says Kaffenberger. “The National Psoriasis Foundation is a good resource for patients. Becoming linked with others with psoriasis can reduce stress.”

6. Skin injury. “If you have active psoriasis, a physical trauma to the skin can develop a new area of psoriasis,” Katz says. “This is called the Koebner phenomenon.” Vaccinations, sunburns, bruises, scrapes, surgeries, poison ivy, poison oak, or bug bites can all trigger a psoriasis flare. Take safety measures, such as wearing protective clothing and using sunscreen to prevent harm, and treat injuries or burns quickly to help prevent infection and inflammation.

7. Weather. For most psoriasis patients, the onset of cold, dark days can trigger symptoms. “Winter is worse because there is not as much sun,” says Kaffenberger. Sunlight dramatically improves symptoms because the sun’s UV light reduces inflammation. But you still need to take precautions, like using sunscreen and wearing protective clothing, to protect your skin. Too much sun can aggravate your psoriasis.

Doctors often treat psoriasis patients in the office with light therapy, which provides a measured dose of UV light in a safe and controlled environment (note: therapeutic UV lights are not the same as tanning beds). If your symptoms get worse in the winter, talk to your doctor about light therapy.

Katz says the decrease in humidity and dropping temperatures can also dry out your skin, which aggravates psoriasis. She recommends liberal moisturizing with an unscented lotion, preferably one that is mostly free of preservatives.

The good news, says Kaffenberger, is that doctors now have treatments that can get psoriasis well under control. Using effective medical treatments, reducing stress, and managing triggers can all help control your psoriasis symptoms.

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